Protocols - Hemorio

SPECIAL CARES
DEFERASIROX
- The use in pregnant women is not recommended
- Visual and earring problems are more common in younger patients at high doses and
prolonged use
- Association with vitamin C must be used with caution in elderly patients, because they
are more likely to develop cardiac problems
- Patients with renal problem have higher chance to experience side effects
- Occurrence of orange urine may follow all treatment period
- Discharge from MS, in 2006.
- It must be used by PO, at 30mg/kg dose in patients continuing transfusion regime
- Patients that are not at transfusion program, the dose can be adjusted to 20
mg/kg/day, and the iron balance must be monitored.
- Presents only fecal elimination
- The must be monitored on liver and renal function test monthly
- The most frequent side effects are gastric intolerance and intestinal disturbs. This
manifestations are, generally, mild and the drug seems to be well-tolerated .
20. HYDROXYUREA
ELIGIBILITY – INCLUSION CRITERIA TO PROTOCOL:
1. Hemoglobin electrophoresis - SS, SC, SD ou Sβ 0 tal;
2. Older than 3 years old;
3. To show at periodic revisions;
4. Submit to lab exams every 2 weeks, at first month and, after, monthly;
5. Pregnancy test (β-HCG serum) negative for childbearing women;
6. At least one of the
complications, in the
last 12 months:
- 3 or+ episode of vaso-occlusive crisis with medical consultation requirement
- 2 episodes of STA (defined as acute thoracic pain with new pulmonary infiltrate fever
37,5 o C or superior, taquipnea, pulmonary wheezing or cough);
- 1 episode of severe priapism our recurrence of priapism;
- bone ischemic necrosis;
- renal insufficiency
- 24h proteinuria higher or equal to 1 g
- Severe and persistent anemia (Hgb < 6,0 on three dosage in 3-month period).
- Elevated LDH 2-fold normal in children and above 3-fold in adult
- 2 DTC above 160 and up to 200 cm/s
- patients with proliferative retinopathy
- any other situations where there is an evidence of organ chronic lesion
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